Microsoft word - bowel prep may 2009.doc


Have there been any changes in your health status?

Please notify Dr. Moein if you experience any significant change in your health status, such as developing a cold, influenza, a bladder infection, diarrhea, or other infection, before your surgery.

Pre-Operative Medication Instructions

Unless specifically instructed otherwise by Dr. Moein, your cardiologist, or anesthesiologist, please observe the following guidelines for taking your medicines before surgery:
One week prior to surgery:
• STOP taking all aspirin and all aspirin-containing medicines such as Anacin, Excedrin, or Pepto-Bismol. Check any cold or pain medication bottles to make certain aspirin is not contained. Two days prior to surgery:
• STOP taking all nonsteroidal anti-inflammatory medications, such as etodolac [Lodine], fenoprofen [Nalfon], ibuprofen [Advil, Motrin, Nuprin], ketorolac [Toradol], maproxen [Aleve], meclofenarnate [Meclomen], mefenamic acid [Ponstel], or naproxen [Anaprox, Naprosyn]. • STOP taking all other medications or herbal remedies that may make you bleed more easily, such as Vitamin E • If you are taking Coumadin or Clopidogrel, ask Dr. Moein if you should stop taking it. The day before your surgery:
START the pre-operative bowel preparation procedure that is appropriate for this surgery. Your surgery occurs near
the bowels and requires bowel preparation as follows:
• Take 4 ounces (1/2 cup) of Magnesium Citrate every 2 hours, beginning at 10:00 a.m., and continuing until the • The night before your surgery, if your stool is not clear fluid, do 1-2 Fleet Enemas four hours apart until stool is clear. And again the morning of your surgery if needed. On the morning of your surgery:
• DO NOT TAKE digitalis medicines such as Crystodigin, Digoxin, or Lanoxin. • DO NOT TAKE oral antidiabetes medicines such as chlorpropamide [Diabinese], glyburide [DiaBeta, Glynase, Micronase], glypizide [Glucotrol], tolazamide [Tolinase], or tolbutamide [Orinase]. • If you are diabetic, TAKE one-half of your usual morning insulin dose. DO NOT TAKE your morning INSULIN dose if you are driving a great distance the morning of surgery or if your surgery is scheduled for the afternoon. • TAKE ALL of your other usual morning doses of regularly prescribed medicines with a small sip of water. You should also use any asthma inhalers and bring them with you to the hospital.
Pre-Operative Diet Instructions

Unless specifically instructed otherwise by Dr. Moein or your anesthesiologist, patients of all ages must observe the following diet restrictions before surgery: • Two days before your surgery, begin a diet of soft foods with no meat or cheese.
The day before your surgery, begin a clear liquid diet consisting of water, black coffee, black tea, clear juice
such as apple juice, broth (without any “bits”), sports drinks and soda pop. Do not eat ANY food or drink ANY milk or cloudy juices. This includes gum, cough drops and throat lozenges. You may continue to drink up to eight ounces of clear liquids until EIGHT hours before the scheduled start of your surgery. • Eight hours before the scheduled start of your surgery, DO NOT TAKE anything by mouth except for any of
your usual medicines that are allowed by the preoperative medication instructions above. Patients undergoing any procedures involving sedation must refrain from eating, drinking or taking anything by mouth for a stated period beforehand to prevent nausea or vomiting while he or she is unconscious. Should you vomit while unconscious, there is a risk that you may inhale the vomit and contract pneumonia or some other serious complication that will require a longer hospital stay. So don’t eat or drink anything after midnight before your operation the anesthetist tells you to. Do not smoke for at least 12 hours before and after your surgery.
Pre-Operative Showering Instructions

Take a shower the night before and the morning of your surgery just before leaving for the hospital. Use either Betadine or Hibiclens Surgical Scrub antibacterial soap to remove as much bacteria from your skin as possible prior to your surgery. If you are allergic to these products please notify Dr. Moein or your nurse. • Generously lather your body, scrub well, and rinse. Give particular attention to the area where the incision will be • After your shower the morning of the surgery, do not apply creams, body oils, lotions, perfumes, deodorants, makeup, lipstick, nail polish or any other cosmetic product to your skin or nails. • Do not use Hibiclens on your face. You may use any other antibacterial soap for the face.

The Day of Your Surgery
• Take your medicines as instructed above.
• You may brush your teeth, but when rinsing your mouth, do not swallow the water.
• Leave all jewelry (including wedding and all other rings) and valuables (including money and credit cards) at
• If you wear contact lenses, glasses, or hearing aids, please bring a case or container for them as well as any contact solution to protect them while you are in surgery. • Wear a minimal amount of makeup and no mascara. Please remove the nail polish from both index fingers. Wear • Please have a friend or relative drive you to the hospital. • Please bring a copy of your current medical problem list from your primary care physician. If you have received a prescription for medications to be used after surgery, have the medications available. • The anesthesiologist will discuss with you the anesthetic most appropriate for your medical condition and any
After Your Surgery

For the first 24 hours after surgery, you should not: Be sure to follow all your discharge instructions and make a follow-up appointment as instructed. If you have any questions, please call us on 858-487-2877.


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